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Fracture of alveolar process
03-09-2009
Isolated fracture of the alveolar process is the result of an inflection or shift in the place of application of force. Most widespread classification of fractures of the alveolar process, developed KS Sound (1968). According to this classification are the following types of fractures:
▲ partial – the line of fracture passes through the outer part of the alveolar process; fracture occurs outside of a compact disc within the wells of several teeth and part of the interdental partitions;
▲ part – the line of fracture in the form of cracks through the entire thickness of the alveolar process, capturing the outer and inner compact discs, sponge, displacement of fragments does not occur;
▲ complete – two vertical lines of fracture united by one horizontal and pass through the entire thickness of the alveolar process;
▲ comminuted – the line of fractures intersect in several directions;
▲ to the bone defect – separation of broken alveolar bone.
Alveolar bone of the upper jaw is broken more often than the lower appendage. This is due to anatomical features. It is known that the teeth and alveolar bone of the upper jaw in most patients several overlapping teeth and alveolar part of mandible, alveolar bone is thus more vulnerable to a stroke in the frontal plane. The only obstacle in this case, ie protection for him, is only part of the cartilage of the nose, whereas the alveolar part of mandible under the same conditions, is protected speakers chin mound and alveolar bone of the upper jaw (with the broad area of subject matter offends). In addition, the alveolar bone of the upper jaw is longer and thinner such as the appendix of the mandible. Compact discs it is also thinner and imbued with plenty of holes for blood vessels and nerve Stalks. Alveolar bone breaks mainly in the frontal section, at least – in the side.
For side impact, where the force is applied in a large area, the protection for the alveolar lateral division of the lower jaw may be the zygomatic arch and bone, and thickened due to bias the lateral part of the body of the mandible. A broken fragment of alveolar bone is displaced, usually in the direction of acting forces: at the turn of the frontal section – backwards into the oral cavity, and at the turn of the lateral section – medially, in the mouth. Additionally otlomok can still turn around its longitudinal axis. The upper jaw in the frontal section, he can shift outwards when the effect on alveolar bone is mediated through the teeth of the lower jaw, ie suffered a blow on the chin upwards in a patient with deep bite in the absence of molars and premolars.
Chance fracture of the alveolar bone of the upper, less alveolar part of mandible in the frontal section when removing incisors and canines, when forceps pushed too deep under the mucous membrane of the gums, capturing their alveolar bone. This, together with the remote part of the tooth breaking the alveolar process. Sometimes breaks alveolar bone of the upper jaw in the lateral section with the removal of the upper third molar. It breaks off and part of the hill of the upper jaw. Broken-off section of the alveolar process often saves us from the periosteum and mucous membrane with at least one side, sometimes it is a complete separation. Fracture of alveolar process is often accompanied by a fracture or dislocation of the teeth. Line fracture is always arcuate shape. So, starting at the crest of the alveolar bone in the interdental spaces, it rises up, passes along a few teeth with varying levels of location of roots and tops of non-uniform thickness of a compact disc according to them, then sinks down between the teeth to the crest of the alveolar process.
Fracture of lateral part of the alveolar process occurs when striking a blow by a narrow object (crowbar, pipe, metal rod, etc.), which runs between the zygomatic bone and the body of the mandible. At the turn of the lateral portion of the alveolar process of maxilla can occur broke off the bottom of the maxillary sinus. Fracture line often passes outside the roots of teeth, ie on the upper jaw – above the tops on the bottom – below them. More rarely, it can be located within the roots of the teeth, combined with their break in the apical third. In the second case, the conditions for treatment are extremely unfavorable, and otlomlenny fragment often survives.
Patients may complain of bleeding from the mouth, the pain of the spontaneous nature of the upper or lower jaw, with the increasing interdigitation or try chewing food; incorrect tooth contact or the inability to close them because of the pain. The complaints associated with a blow to the face more narrow subject. There have pronounced swelling of soft tissues in prirotovoi area, cheeks; bruises, wounds, bruises. Roth often parted, sometimes identified with the blood stained saliva. On the mucous membrane of the lips or cheeks – tear-contused wounds, bleeding due to damage to the soft tissues of the teeth at the moment of impact. When displacement occurs fragments break the mucous membrane of the alveolar process by the fracture. A wound in the mucosa may be visible fracture of the bone tissue. Configuration of the dental arch broken: broken teeth on the fragment shifted in the mouth or in the direction of the occlusal plane. Therefore, the closing of their teeth are in contact, just a change area of the alveolar process. They often are mobile, percussion them painful.
Sometimes, after a strong dramatic impact can be observed two fairly typical variants of the clinical picture:
• When viewed from the arches of the mouth front teeth are not visible in their place are scalloped «curtain» scalped from the outer surface of the alveolar process of the mucous membranes. Several lifting her, you can see that the alveolar bone is almost horizontal position and the line of fracture faces forward. Of this bone wounds appear tops
roots of teeth;
• the second option in anticipation of the mouth is visible a long and extensive bone injury. A broken alveolar bone with preserved mucosa it takes the position that is close to horizontal, and the surface of his knee is under the bone wound in the body of the jaw. From the alveolar process may make the tops of the roots of teeth. Gap mucosa can not be with a slight displacement of fragments, or the absence of it. However, necessarily determined by bleeding on the crease in transition, the most intense in the projection of the fracture line.
Percussion of teeth, between which is fractured, painful. If no clinically bias fragments, the fracture line can be determined by carefully shifting the alleged fragment in anteroposterior or vestibular-oral direction and palpation defining fingers of the other hand his mobility. Projecting a number of fixed points on the mucous membrane of the gums, it can be played on a projection of the fracture line.
X-ray study allows to confirm the diagnosis: fracture line of the alveolar process of maxilla is visible as a band of enlightenment with fuzzy and jagged edges. In this line of mandibular fracture more clearly that the difference is explained by its anatomical structure. By x-ray can also trace its relationship with the tops of the teeth fragments.
For the differential diagnosis of a fracture of the alveolar process of fracture and dislocation of the teeth, you can use this trick: placing a finger on the vestibular surface of the alveolar bone and shaking one tooth in the anteroposterior direction, we may experience mobility otlomlennogo alveolar bone fragment. In dislocation of the tooth was not accompanied by the swaying of this ground and is determined only by the mobility of the root of the tooth, and at the turn of the root – only offset part of the root of the tooth.
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Comments
Гость:Hello, My story is the same as so many others you have heard. To be as breif as I can, I am 48 and have been inunrg for about 4 years on and off, mostly 3-4 mile 4-5 days a week. Last year I became more serious and ran 2 -1/2 marathons as well as completed the 9 races in NYC to qualify for the marathon in 09. As luck would have it, I was also excepted in 08’s marathon. I began training and by mid july last year I was diagnosed with a stress fracture(after being told it was only a shin splint). I was up to 18 miles at that time and the pain grew so that I could not proceed. I took off a few months, and did not do the 08 marathon. Now it is 09, I saw a specialist and I was dianosed with a soft arch bought very expensive orthodics and began to slowly train. Around my 10 mile long run, the same pain reoccured in the same spot on the same leg. I went back to the Doc, and he gave me an injection to relieve the inflamation and made a minor adjustment to my orthodics. I believe it is broke again by the feel, but not sure I really want a 3rd bone scan or MRI in 18 months to prove it. Can I cross train with a bike, and wear a brace so I can contnue to run this fall? I think iif I cross train, and only run 18 once, then 20 once I should be able to do 26. Please help Гость:Hello, My story is the same as so many others you have heard. To be as breif as I can, I am 48 and have been inunrg for about 4 years on and off, mostly 3-4 mile 4-5 days a week. Last year I became more serious and ran 2 -1/2 marathons as well as completed the 9 races in NYC to qualify for the marathon in 09. As luck would have it, I was also excepted in 08’s marathon. I began training and by mid july last year I was diagnosed with a stress fracture(after being told it was only a shin splint). I was up to 18 miles at that time and the pain grew so that I could not proceed. I took off a few months, and did not do the 08 marathon. Now it is 09, I saw a specialist and I was dianosed with a soft arch bought very expensive orthodics and began to slowly train. Around my 10 mile long run, the same pain reoccured in the same spot on the same leg. I went back to the Doc, and he gave me an injection to relieve the inflamation and made a minor adjustment to my orthodics. I believe it is broke again by the feel, but not sure I really want a 3rd bone scan or MRI in 18 months to prove it. Can I cross train with a bike, and wear a brace so I can contnue to run this fall? I think iif I cross train, and only run 18 once, then 20 once I should be able to do 26. Please help Гость:VQOSaz kuxfjxjtpyfq Гость:y4U7FU , [url=http://dlrturudlrol.com/]dlrturudlrol[/url], [link=http://pyyhfwzaspfg.com/]pyyhfwzaspfg[/link], http://gxcnrltsqvje.com/ Гость:xI5HXF sjiejosjpklo Гость:AS1bHT , [url=http://bvjzubuudxcx.com/]bvjzubuudxcx[/url], [link=http://czxfoiqlkned.com/]czxfoiqlkned[/link], http://lxsavqkeecvm.com/ Гость:came by to say hi !you have really been potisng I have miss out ,but enjoyed getting caught up :)hope to be bloging again soon August feels so crazy and its really staring to get really hot and I am ready for the kids to be back in school .sorry to hear about your daughter its so hard on them when they are use to being so busy.marina Гость:Oh yeah, faoublus stuff there you! Гость:I think I have permanent nerve damgae from having a dental implant put in. I had the surgery back in Sept 2006. Its now Oct 2007 and the pain is only getting worse. I have pain, tingling and numbness in my lip and chin. When the weather gets colder outside, it seems to hurt worse. I am debating a lawsuit with the doctor who performed the surgery. Any suggestions? I am not concerned about money I just want this repaired as soon as possible. Its affecting my smile and speech. Do you know of any cures for this? I would love to have feeling again in my face. Гость:Thank you so much for your comments. You have given me hope. I am 40 yrs old, in otiwrehse good health, and have suffered from parasthesia for 3 wks now from wisdom teeth extraction (2 on bottom, and one on top). I will try these remedies. This minor surgery too has consumed every waking moment of my life. To think that I was so worried about dry sockets. Ha! I had no idea that this parasthesia was something that I should really be concerned about. Thanks again. I appreciate your comments! http://wzhsxdxpyb.com [url=http://fyayzta.com]fyayzta[/url] [link=http://qjvjnygy.com]qjvjnygy[/link]
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Articles for theme “fracture of the tooth”:
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03-09-2009
Treatment of patients with fracture of the crown of the tooth is aimed at restoring the lost crown of the tooth tissue. In the case of fracture of the tooth at the cervical orthopedic methods of reconstructing the lost crown a more promising, if the fracture line passes over extragingival attachment (making pins tooth crowns Stump). Sometimes to implement the plan of orthopedic treatment appropriate excision of the edges of the mucous membrane. In the literature there are indications of the effectiveness of orthodontic preparation for orthopedic treatment.
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